Our wrists are essential to virtually all our activities. Hand or wrist pain can be debilitating. What are the wrist ligaments? What are the symptoms of a torn ligament in the wrist? What are the treatment options for Wrist Ligament Injuries? Why are they important? Let’s dig in.
What Are the Ligaments of the Wrist?
The wrist is composed of eight small carpal bones and the bones of the forearm, the radius, and ulna. Ligaments are thick bands of connective tissue that connect one bone to another. The wrist has an extensive network of ligaments that can be divided into two types.
Intrinsic Ligaments: Connect exclusively the wrist bones to one another. Examples include the scapholunate ligament.
Extrinsic Ligaments: Connect the wrist bones to the forearm bones. Examples include dorsal and volar radiocarpal ligaments
Wrist ligaments provide important stability to the wrist. They stabilize the small wrist bones against the forces of daily living and are susceptible to injury which is called a sprain. Approximately 25% of all sports-related injuries involve the hand or wrist (1) Ligament injuries are graded from one to three based upon their severity.
Grade 1: Is a partial sprain without instability.
Grade 2: Intermediate sprain with partial thickness tear of the ligament
Grade 3: Complete tear of the ligament
There are two major types of wrist sprains that are based on location. A radial sprain involves the ligaments on the thumb side of the wrist, whereas an ulnar sprain involves the ligaments on the pinky finger side.
What Are the Symptoms of a Torn Ligament in the Wrist?
Trauma and sports can cause injury to the ligaments in your wrist. The most common mechanism of injury is a fall on an outstretched hand or arm (2). Evaluation is important and will include reviewing the history of prior injuries, current injury, and significant medical history. During a physical examination, the wrist is put through specific tests to assess wrist integrity (3). Common symptoms include
- Reduced range of motion
- Snapping or popping in the wrist
Additional studies may be requested and can include x-rays, MRI, CT, and Ultrasound. Ultrasound uses high-frequency sound waves to create detailed images of the bones, tendons, and ligaments. Most physicians refer patients to a hospital or imaging center for ultrasound studies. Unfortunately, this puts you at risk for viral infection and delays. At the Centeno Schultz Clinic, ultrasound imaging is part of every new patient evaluation.
Specific treatment will depend upon the severity of the wrist ligament injury and the presence or absence of cartilage damage. Grade 3 tears which involve complete rupture of the ligament requires surgery. When possible, conservative treatment is the first line of treatment.
Conservative Care: Rest, immobilization, compression, safe anti-inflammatory medications such as fish oil and Turmeric, stretching, PT, and proprioceptive training (4).
Injections: When conservative care fails, steroid injections are oftentimes recommended. While steroids are strong anti-inflammatory agents, they cause damage to ligaments and cartilage and can compromise your immune system (5). Steroids should be avoided.
Surgery: Various surgical options exist for injuries of wrist ligaments depending on the severity of the injury, instability, and cartilage injury. Complications include bleeding, infection, loss of range of motion, instability, and complex regional pain syndrome.
Are there other options? Absolutely!
Precise Biologic Injections
Grade 1 and 2 wrist injuries can be treated with precise ultrasound injection of PRP or bone marrow concentrate. PRP is rich in platelet growth factors that can increase blood flow and accelerate ligament healing. Bone marrow concentrate contains many different types of your own body’s cells that can promote ligament healing and reorganization of the disrupted fibers. At the Centeno-Schultz Clinic, we are experts in the treatment of ligament hand ligament pain and injuries. The procedures are demanding and require advanced training. Wrist ligaments are small in size and require ultrasound guidance to be injected. Injections without ultrasound guidance, otherwise known as blind injections, can not accurately target and treat specific ligaments. To learn more about precise ligament injections watch Dr. Pitts in the video below.
Why are Wrist Ligaments Important?
Ligaments connect one bone to another and provide important stability for the wrist. Injury of the ligaments in your wrist can disrupt this stability resulting in wrist instability. This is similar to a loose lug-nut on your car wheel. The excessive play in the wheel compromises your ability to drive, the safety of the car and leads to premature wear and tear of the tire. So too with the wrist. Loose ligaments allow excessive motion in the joint which can cause injury to the ligaments, tendons, and the onset of arthritis.
Five Key Facts
- The wrist has an extensive network of ligaments which can be divided into the intrinsic and extrinsic ligaments
- Wrist ligaments provide stability for the wrist
- Wrist Ligaments are susceptible to injury which are called sprains and are graded.
- Wrist ligament injuries if left untreated can lead to additional injuries and the development of wrist arthritis.
- Most wrist ligament injuries can be treated with ultrasound-guided PRP and stem cell injections
Wrist ligaments provide important stability for the wrist and are susceptible to injury. If left untreated they can result in additional wrist injuries and the development of wrist arthritis. Wrist ligament pain is a warning sign that requires attention. Precise ultrasound-guided injections of PRP and stem cells are an effective treatment for most wrist ligament injuries that avoid the risks of surgery. Don’t get sidelined by wrist pain and arthritis. Schedule a Telemedicine consultation from the comfort of your home or backyard, and learn more about your treatment options.
1.1.Rettig AC. Athletic injuries of the wrist and hand. Part I: traumatic injuries of the wrist. Am J Sports Med. 2003;31(6):1038-48.
2. Roald Bahr, Sverre Maehlum. Clinical Guide To Sports Injuries. 2004.
3.Fufa DT, Goldfarb CA. Sports injuries of the wrist. Curr Rev Musculoskelet Med. 2013;6(1):35-40.
4..The effectiveness of proprioceptive training for improving motor function: a systematic review. Aman JE, Elangovan N, Yeh IL, Konczak J Front Hum Neurosci. 2014; 8():1075.
5.Wernecke C, Braun HJ, Dragoo JL. The Effect of Intra-articular Corticosteroids on Articular Cartilage: A Systematic Review. Orthop J Sports Med. 2015;3(5):2325967115581163.